CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Wellstar Paulding Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,135
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Wellstar Paulding Medical Center is $15,135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.07x the Medicare baseline. Located in 2518 Jimmy Lee Smith Parkway, Hiram, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,135

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)
Insurance Median: $15,135 (107%)
Ins. Median: $15,135 (107% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,116.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $14,145 - $54,397 100%
Cigna $14,145 - $78,696 100%
Blue Cross Blue Shield $14,428 - $68,851 102%
Humana $14,428 102%
UnitedHealthcare $14,428 - $55,037 102%
Clear Spring $14,853 105%
Wellcare $14,853 105%
Caresource $15,135 - $27,725 107%
Clover $15,135 107%
Pruitt $15,135 107%
Sonder $15,135 107%
Ambetter / Centene $24,896 176%
Oscar Healthplan $26,169 185%
Peachstate $26,169 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2518 Jimmy Lee Smith Parkway, Hiram, GA 30141
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals